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Sub-theme 2: Factors to enhance return to school
Under category 2, factors to enhance return to school, three subcategories emerged, namely community/ parental/personal encouragement; family/partner support, and day care for baby near school.
Community/ parental/personal encouragement
Encouraging teenage mothers to continue with their schooling after delivery was a delicate issue for the teenage mother participants from the two rural villages. Strict cultural and traditional rules applied to teenage girls‘ sexual behaviours while boys apparently went scot-free. Parents and teachers were inclined to avoid talking about sexual and reproductive health and gave incorrect information. Despite many challenges, the teenage participants showed great determination to complete their schooling as the following verbatim quotes verify:
―I think I should be serious with my studies and continue to take the contraceptives so that I do not fall pregnant again before I am ready. But the problem was that, both of my parents were working and I was forced to take care of the baby until he was old enough to go to a day care centre whilst I returned to school.‖ (Participant 10)
―As a teenage mother, I must make a decision about my education and future and also takes contraceptives. We as teenagers, we should learn to communicate with our parents so that they can allow us to return to school.‖ (Participant 15)
―As teenagers, we must learn to communicate and to listen. I must use contraceptives especially the new one of implants as it will sustain me for long. I will be able to complete my studies and have a profession. Employment will be possible.‖ (Participant 13)
Regarding personal encouragement, participants indicated that they wanted to return to school to complete their studies. Some said they had started to use contraceptives to prevent another pregnancy. However, the problem was that they needed someone like their parents to remain with the baby while they attended classes. Basch (2011:616) supports the development of future aspirations such as completing high school and college in order to better a mother‘s life and future and at the same time contribute to the community and society. As reiterated by a participant who said she ―will be able to complete my studies and have a profession‖. Mahlalela and Chireshe (2013:140) also indicate that teenage mothers‘ pregnancy made them realise they had to think and work for a better future for them and their children and they therefore took education seriously when they returned to school immediately after delivery.
But, the findings showed even though young mothers were determined to return to school, the obstacles they faced in their communities and families were immense. There was the general feeling that educators at both schools did not approach teaching learners on sexual and reproductive health correctly; the traditional tenets that talking about sex is taboo, abstaining from sex is compulsory and boys are viewed as worthier than girls, these upset the participants. The following quotes verify this:
―The teachers should deal very deeply with the subject in Life Orientation especially the reproductive system. They teach light information because talking about sex is a taboo. The community should also be involved in teaching us about health, not calling us prostitutes when having a boyfriend.‖ (Participant 12)
“In the community, they will say that a child will become barren because the contraceptive she takes is in her bloodstream or body and she will never fall pregnant. The term taboo should be eliminated.‖ (Participant 11)
―Families, churches, chiefs and community developers should work together to groom children from early stage. The term taboo should be eliminated and parents start teaching us the truth about sex. Lack of knowledge makes us to be pregnant. The boys have no problems because only girls are considered to be responsible for pregnancy but they [all teenagers] should be told about the dangers of unprotected sex such as sexual transmitted infections.‖ (Participant 15)
The communities of Muyexe and Homu 14C villages strongly object to pregnancies among teenagers before marriage since as a community, most families seem to promote the traditional culture of abstinence. In a community where misconceptions about using contraceptives (―the contraceptive she takes is in her bloodstream or body and she will never fall pregnant‖); being judged as a ―prostitute‖ for having a boyfriend and parents and teachers failing to communicate correct information to the teenagers regarding sex (―They teach light information because talking about sex is a taboo.‖) prevail it is likely for girls to regarded as inferior to boys. This supposition is confirmed by the verbatim quote that the ―boys have no problems because only girls are considered to be responsible for pregnancy”.
Thobejane (2015:274) reflects that teenagers receiving inaccurate, inappropriate and confusing information about sexuality and reproductive health remain a problem in South Africa – particularly in remote areas. Bana, et al (2015:154-5) fully agree in economically poor rural populations young people‘s knowledge of preventing HIV and STIs and condom and contraceptive use is alarming.
In a rural area in the Eastern Cape (population approximately 36 000), these authors discovered many 15- to 24-year-old learners were unaware of what STIs were but believed it was a ―female disease‖; they had ―some vague idea about other STI syndromes like discharge and ulcers‖; had only heard about HIV and AIDS; and were unclear about the different methods of contraception and how it linked to STIs including HIV prevention (Bana, et al 2010:154-5). According to UNFPA (2013:50) parents may ―impart information about sexuality and prevention of pregnancy or they may withhold vital information‖.
Parents‘ roles and how they view the roles of their sons and daughters in the family and in life itself play a pivotal part in whether girls grow up believing their destiny is to marry, have children and look after their husbands or whether they have the right as individuals to have equal rights as boys to education and developing life skills to become autonomous and take control over their own future. Sadly, parents ―who succumb to community pressures usually force their girls into marriage and a lifetime of dependency‖ (UNFPA 2013:50). The current participants verbalised again and again discussing sexuality is ―taboo‖ whether in the household, school, church or with peers.
This indicates networking on sexuality (vertically with parents) and horizontally (with community-based structures like school teachers, nurses, church and tribal leaders) is non-existent or not utilised properly (Modiba, Schneider, Weiner, Blaauw, Gilson, Zondi, et al 2002:i). In early the early 2000s Caldwell and Caldwell (2002:para 1-2,5) found urbanised single young women already replaced traditional postpartum sexual abstinence with contraception in sub-Saharan countries such as South Africa, Lesotho and Botswana but in most rural areas life was still lived according to traditional customs prescribing abstinence as the only way to prevent young girls to become pregnant. In the current study setting, abstinence only was promoted by educators in schools and in churches; parents at home and the community at large. It was only after having unprotected sex and falling pregnant that participants who were sexually active realised the importance of using contraceptives.
The participants verbalised again and again their dismay with the fact that discussing sexuality was ―taboo‖ whether in the household, school, church or with peers. This indicates networking on sexuality (vertically with parents) and horizontally (with community-based structures like school teachers, nurses, church and tribal leaders) is non-existent or not utilised properly (Modiba, et al 2002:i). Therefore, participants pleaded for ―families, churches, chiefs and community developers should work together to groom children from early stage,‖ and for parents to start telling both sons and daughters ―the truth about sex. Lack of knowledge makes us to be pregnant … [all children] should be told about the dangers of unprotected sex such as sexual transmitted infections‖.
According to Chigona and Chetty (2008:274), the communities in which teenage mothers live have a significant impact on their lives. These authors assert that instead of being supported to complete their schooling, teenage mothers in traditional communities are discouraged and often treated as a girl with low morals – being stigmatised as a ―prostitute‖ was mentioned in this study. Gender-bias was also observed. This is in stark contrast to the standpoint of UNFPA (2016:76) that from young age boys should be educated to respect girls and acknowledge them as human beings and vice versa.
CHAPTER 1 ORIENTATION OF THE STUDY NUMBER TOPIC PAGE NUMBER
1.1 INTRODUCTION AND BACKGROUND
1.2 PROBLEM STATEMENT
1.3 RATIONALE
1.4 RESEARCH QUESTION
1.5 AIM AND OBJECTIVES OF THE STUDY
1.6 SIGNIFICANCE OF THE STUDY
1.7 CONCEPTUAL CLARIFICATIONS
1.8 RESEARCH PARADIGM AND PHILOSOPHICAL ASSUMPTIONS
1.9 CONCEPTUAL FRAMEWORK
1.9.1 Overview of the model
1.9.2 Alignment of Pender‘s revised model with naturalistic study design
1.10 RESEARCH DESIGN AND METHODOLOGY
1.11 ETHICAL CONSIDERATIONS
25 NUMBER TOPIC PAGE NUMBER
1.12 ORGANIZATION OF THE STUDY
1.13 CONCLUSION
CHAPTER 2 RESEARCH DESIGN AND METHODOLOGY NUMBER TOPIC PAGE NUMBER
2.1 INTRODUCTION
2.2 OBJECTIVES
2.3 RESEARCH DESIGN AND METHODOLOGY
2.3.1 Research method
2.3.2 Study context
2.4 DESCRIPTION OF POPULATION
2.4.1 Population
2.4.2 Sampling
2.4.3 Inclusion Criteria
2.4.4 Exclusion Criteria
2.4.3 Data collection
2.5 DATA ANALYSIS
TRUSTWORTHINESS OF THE STUDY
2.6.1 Credibility
2.6.2 Dependability
2.6.3 Confirmability
45 NUMBER TOPIC PAGE NUMBER
2.6. Transferability
2.7 DEVELOPMENT AND VALIDATION OF GUIDELINES ON PROMOTING HEALTH AND WELBEING OF TEENAGE MOTHERS IN MOPANI DISTRICT, LIMPOPO
2.7.1 Development of guidelines
2.7.2 Methodology of guidelines development
2.7.3 Guiding attributes in this study for the development and validation of guidelines
2.7.4 Guidelines developers
2.7.5 Validation of guidelines by experts
2.7.6 Review guidelines
2.8 CONCLUSION
CHAPTER 3 DATA ANALYSIS, DISCUSSION OF FINDINGS AND LITERATURE CONTROL NUMBER TOPIC PAGE NUMBER
CHAPTER 4 DISCUSSION OF EMPIRICAL FINDINGS OF RESEARCH WITH REFERENCE TO PENDER’S REVISED HEALTH PROMOTION MODEL NUMBER TOPIC PAGE NUMBER
CHAPTER 5 DEVELOPMENT OF GUIDELINES FOR PROMOTING HEALTH AND WELLBEING OF TEENAGE MOTHERS IN MOPANI DISTRICT, LIMPOPO, SOUTH AFRICA NUMBER TOPIC PAGE NUMBER
CHAPTER 6 REVIEW OF THE FINDINGS, VALIDATION AND DESCRIPTION OF THE GUIDELINES WITH APPLICABLE RECOMMENDATIONS, LIMITATIONS, IMPLICATIONS AND CONCLUSIONS
